Combining treatments for post-traumatic stress disorder and substance abuse resulted in improved PTSD symptoms without worsening symptoms of substance abuse, according to a study released Tuesday in the Journal of the American Medical Association.The findings, explain the Australian researchers, are contrary to conventional wisdom on how to treat PTSD and substance abuse, which commonly co-exist in patients. The common belief, they explain, has been that using the so-called "gold standard" of PTSD treatment might exacerbate substance abuse by resurfacing negative memories.
Therefore, people with substance abuse and PTSD have commonly been excluded from prolonged exposure therapy-based PTSD treatments and clinical trials using exposure therapy.
Prolonged exposure therapy is considered one of the most effective PTSD treatments. In fact, prolonged exposure therapy is the only "treatment for PTSD endorsed in a U.S. Institute of Medicine study as evidence based," according to corresponding study author Katherine L. Mills of the University of New South Wales.
During the therapy, patients work with therapists to go back to their traumatic event and describe it in present tense, allowing the person to relive the trauma. By repeating this process, the brain reacts less severely over time, making the memory seem less traumatic.
University of New South Wales researchers enrolled 103 participants in their trial. All participants met the diagnostic criteria for both PTSD and substance abuse. The subjects were randomly selected to either receive both prolonged exposure therapy and treatment for substance abuse, or to only receive treatment for substance abuse.
At the nine-month mark, while both groups experienced reductions in PTSD symptoms, the subjects in the combined treatment group also showed a reduction in the severity of their PTSD symptoms without any increase in the severity of their substance abuse.
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